Answer 1:

Chronic respiratory acidosis

Answer 2:

PAO2 (at 0100) =

150-(1.2x 58 )= 80

Answer 3:

PAO2-PaO2 = 80-44 = 36

Indicates abnormal gas exchange

Answer 4:

Hypoventilation

V/Q abnormality

Answer 5:

Renal effort to compensate for Respiratory acidosis.

The process is chronic

Answer 6:

To treat acute bronchitis

• Streptococcus pneumonia
• Moraxella catarrha
• Hemophilus influenza and
• Viruses

are the common organisms to cause acute exacerbation in COPD.

Answer 7:

Hypoxic stimulus to increase ventilation abolished by oxygen administration

Answer 8:

Hypoxemia due to V/Q abnormality rather than shunt

Answer 9:

Patient's decline in FEV1 is approximately 100 ml/yr. (normal 30 ml/yr.)

Answer 10:

Hyperinflation of RV and TLC at the expense of VC

Answer 11:

The patient is more like the classic pink puffer (type A emphysema).

Pink Puffer (type A emphysema):

• Hyperinflation with
• decreased diffusion capacity,
• greater physiologic dead space and
• work of breathing.

Blue Bloater (type B chronic bronchitis):

• Greater physiologic shunt resulting in Hypoxemia and
• early pulmonary hypertension.

Answer 12:

Emphysema:

Loss of elastic recoil (pel)

Chronic Bronchitis:

Increased airway resistance from increased mucous glands and secretions

Asthma:

Increased airway resistance from mucosal inflammation/edema and smooth muscle constriction

 

Answer 13:

Driving Pressure: Pel = Palv - Ppl (pel decreased in emphysema)

Answer 14:

Effort Dependent:

Early and middle portions of curve

Effort Independent:

Last portion of curve (dynamic airway collapse)

Answer 15:

Unopposed outward recoil of the chest wall from loss of inward recoil of lung (decreased Pel)

Answer 16:

Diffusion capacity in:

Chronic bronchitis - Normal

Asthma - Normal or increased

Emphysema - Decreased